Spring 2021 Prof Lavon Williams FINAL EXAM

  1. In child psychotherapy consideration of systems that promote a child’s ongoing
    development include which of the following?
    A
    .
    Peers
    B
    .
    Family
    C
    .
    School
    D
    .
    Communi
    ty
  2. Which of the following is a philosophical approach to psychotherapy which deals with
    universal themes of life?
    A
    .
    Gestalt Therapy
    B
    .
    Psychoanalysis
    C
    .
    Existential psychotherapy
    D
    .
    Person-Centered
    Psychotherapy
    3. Dysregulation of this area of the brain is associated with memory problems and this person
    may be unable to integrate memories into the present and personal memory into identity,
    and thought to underlie symptoms of flashbacks, nightmares, avoidances and dissociation.
    A
    .
    Locus
    coeruleus
    B
    .
    Cerebellum
    C
    .
    Thalamus
    D
    .
    Hypothalamu
    s
    Which of the following is true about communication with children and adolescents?
    A
    .
    Communication is developmentally based.
    B
    .
    Offices should be free of toys or distractions.
    C
    .
    Speak to children in adult manner as it lets them know you take them
    seriously.
    D
    .
    Communicate at level lower than the child or adolescent to improve
    their self-esteem.
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  3. Question 5
    There is growing evidence that some behavior problems can be prevented in children.
    Effective prevention strategies do not include which of the following?
    A
    .
    Supporting parent’s mental health
    B
    .
    Reducing exposure to stresses
    C
    .
    Helping parents learn ways to stimulate and have positive interaction s with their
    infants and young children.
    D
    .
    Guided exposure to stressors to increase resilience.
    The Dialectical Behavior Therapy (DBT) therapist meets with the client, negotiates the goals
    of therapy, and arrives at a commitment to the treatment. Assumptions and principles of the
    DBT model are explained. This is consistent with which stage of treatment within the DBT
    model?
    A
    .
    Pretreatme
    nt
    B
    .
    Stage 1
    C
    .
    Stage 2
    D
    .
    Stage 3
  4. Question 7
    According to the Trauma Resiliency Model which of the following occurs?
    A
    .
    Emotions precede and underlie physical sensations of
    trauma,
    B
    .
    Physical sensations precede and underlie emotions of
    trauma.
    C
    .
    Physical sensations and emotional sensations occur
    simultaneously.
    D
    .
    None of the above have anything to do with TRM.
    Question 8
    When referring a patient to a 12-step group the advanced practice psychiatric nurse realizes
    which of the following supports successful patient engagement in 12-step group
    participation?
    A
    .
    Provide an overview of the 12-step approach, explain the concept of powerlessness
    and spirituality within the 12-step tradition.
    B
    .
    Use MI to contract for attendance at several different groups to find the right “fit”
    and encourage attendance.
    C
    .
    Encourage patient to not worry about going to the groups because due to high
    attrition rates, most groups have many new patients at each session.
    D
    .
    A and B only
    Which of the following medications may be recommended for patients with insomnia due to
    PTSD?
    A
    .
    Any antidepressant can offer as first-line treatment in
    adults for PTSD.
    B
    .
    Non-benzodiazepines such as trazodone (Desyrel)
    C
    .
    Prazosin (Minipress) may be helpful if nightmares are
    present.
    D
    .
    B and C
    The Gestalt Therapist working with a patient notices that every time a sensitive issue come
    up the patient will change the topic and tell a joke. The therapist recognizes this
    interruption as which of the following?
    A
    .
    Introjectio
    n
    B
    .
    Projection
    C
    .
    Deflection
    D
    .
    Retroflecti
    on
    In working with an older adult patient in the termination phase the advanced practice
    psychiatric nurse suggests it may be helpful to teach family members ways to support the
    patient and prevent relapse. This demonstrates which of the following?
    A
    .
    A major HIPPA violation
    B
    .
    Lack of confidence in the patient and the therapeutic
    process of CBT
    C
    .
    An appropriate strategy to solidify a supportive network for
    the patient.
    D
    .
    Resistance to terminating the therapeutic relationship.
    A specific type of CBT therapies aimed to reduce distress as a person experiences sensation
    with danger is known as which of the following?
    A
    .
    Shame-Attacking
    B
    .
    Exposure Therapy
    C
    .
    Cognitive Rehearsal
    D
    .
    Guided relaxation and
    meditation
    The loss of control over the intense urge to take a drug even at the expense of adverse
    consequences is known as which of the following?
    A
    .
    Tolerance
    B
    .
    Withdraw
    al
    C
    .
    Addiction
    D
    .
    A craving
    The primary source for constructive change in a humanistic-existential approach is which of
    the follow:
    A
    .
    The patient’s motivation
    B
    .
    The therapist’s structure
    C
    .
    The therapist-patient
    relationship
    D
    .
    The patient-family
    relationship
    A Trauma Resiliency Model therapist encourages the patient to describe the “felt sense” of
    internal or external body sensations associated with resilience, stress, and release. This is
    known as which of the following Trauma Resiliency Model skills?
    A
    .
    Tracking
    B
    .
    Resourcing and resource
    intensification
    C
    .
    Grounding
    D
    .
    Gesturing
    Using a Common elements approach with a child with ADHD who despite stimulant
    medication continues to exhibit frequent angry outbursts, opposition and aggression the
    advanced practice psychiatric nurse begin with which of the following?
    A
    .
    Stop the medication as it clearly is not working.
    B
    .
    Adjust medication as it clearly isn’t working.
    C
    .
    Explore inpatient treatment where the environment could be more closely controlled
    and monitored.
    D
    .
    Review the best available evidence for behavioral, cognitive or psychoeducation
    intervention to augment the medication and address these behavioral/regulation
    issues.
    Practice guidelines for complex trauma and dissociative identity disorder caution that which
    of the following may limit one’s ability to heal.
    A
    .
    Somatic approaches
    B
    .
    Talk therapies focused on cognitive
    understanding
    C
    .
    EMDR
    D
    .
    A and C
    Which of the following is consistent with a Common Elements approach?
    A
    .
    Common Elements involves use of individual treatment approaches that are part of
    many manualized treatment
    B
    .
    Evidenced-based strategy is viewed in light of the actual intervention as well as
    diagnostic category.
    C
    .
    The Common Elements method is seen as a transdiagnostic approach to treat a
    variety of common mental health issues.
    D
    .
    Is Common Elements method should not be used with child/adolescents with PTSD.
    Which of the following is not an underlying assumption that differentiates child therapies
    from adult psychotherapy?
    A
    .
    Family inclusion
    B
    .
    The concept of Recovery
    C
    .
    The concept of Resiliency
    D
    .
    Developmental
    considerations
    The person-centered therapist who is genuine and authentic during the therapy session is
    exhibiting which psychological condition?
    A
    .
    Congruence
    B
    .
    Actualizing tendency
    C
    .
    Belief of human nature
    D
    .
    Accurate empathic
    understanding
    Review of child specific Evidence Based Practices (EBP) demonstrate progress in some
    treatment areas however there is still much work to be done particularly in use of EBPs
    guided by diagnostic criteria in children with which of the following disorders?
    A
    .
    ADHD
    B
    .
    Anxiety
    C
    .
    Bipolar Disorder
    D
    .
    Adolescent
    Depression
    The advanced practice psychiatric nurse notices in working with a patient with a dissociative
    disorder that the person appears to be doing worse after significant gains are made. The
    advanced practice psychiatric nurse explains the reason for this is likely which of the
    following?
    A
    .
    This indicates the change(s) really did not take
    B
    .
    The patient is unconsciously sabotaging the therapy.
    C
    .
    This indicates process is trying to force a change too fast.
    D
    .
    As positive changes occur they may be followed by a temporary increase in sadness,
    anger, or anxiety because even positive change may be experienced as a loss.
    The use of medications is indicated in combination with psychosocial interventions in several
    child and adolescent severe emotional disorders (SED) including which of the following?
    A
    .
    Pediatric bipolar disorder
    B
    .
    Mild ADHD
    C
    .
    Antisocial personality
    disorder
    D
    .
    All of the above
    Research suggests that psychodynamic therapeutic approaches are effective for some
    children, particularly those with which of the following disorders?
    A
    .
    Conduct Disorders
    B
    .
    Anxiety and Depression
    C
    .
    Depression and Psychosis
    D
    .
    Attention Deficit-Hyperactivity
    Disorders
    Evidence-based therapeutic modalities for treating older adults with anxiety include which of
    the following:
    A
    .
    Cognitive Behavioral Therapy, Relaxation training,
    Biofeedback
    B
    .
    Dialectical Behavior Therapy, Reminiscence Therapy,
    Biofeedback
    C
    .
    Guided Imagery, Music Therapy, Yoga
    D
    .
    A and C
    The advanced practice psychiatric nurse is working with the patient on maintaining
    treatment outcomes and developing a guide for surviving difficult times. These strategies
    are consistent with which phase in the CBT process?
    A
    .
    Introductory
    phase
    B
    .
    Middle phase
    C
    .
    Late middle
    phase
    D
    .
    Termination
    Which of the following is true about Complementary and Alternative Medicine (CAM)
    Therapies and Older Adults?
    A
    .
    CAM therapies are a good alternative to conventional medicine
    B
    .
    CAM therapies can be used in conjunction with psychotherapy to provide effective,
    evidence-based treatments to older adults with psychiatric disorder.
    C
    .
    Evidence is unclear whether CAM therapies improve quality of life or wellness in
    older adults.
    D
    .
    Most middle age and older adults are reluctant to use CAM therapies for
    management of mental health concerns.
    The advanced practice psychiatric nurse realizes a basic assumption of Dialectical Behavior
    Therapy (DBT) is that therapists treating the difficult patient need support. This support
    includes which of the following?
    A
    .
    The support is provided through case management
    B
    .
    The support is designed to focus on clinical issues of the patient
    C
    .
    The DBT therapist in solo practice does not need a consultation group for support.
    D
    .
    The support includes a consultation group to treat the therapist by using the same
    skills the patient is asked to use.
    During the middle phase of CBT with an older adult the advanced practice psychiatric nurse
    notices that homework is not getting done and suggest that the homework be done during
    the therapy session. This indicates which of the following?
    A
    .
    The patient is not vested in the therapy.
    B
    .
    Clearly the advanced practice psychiatric nurse needs more training in CBT.
    C
    .
    The advanced practice psychiatric nurse is enabling the patient and thus
    undermining the therapy.
    D
    .
    The advanced practice psychiatric nurse is suggesting an acceptable modification to
    facilitate the therapy process.
    Research support that children with serious emotional disorders (SED) are likely to have
    which of the following?
    A
    .
    Children with SEDs are likely to be severely impaired
    B Children with SEDs are likely to have many community agencies involved in their
    .
    care and support.
    C
    .
    Children with SEDs are likely to have a comorbid disorder.
    D
    .
    A and C
    The role of the therapist during Stage 4 of the Dialectical Behavior Therapy procession
    model includes which of the following?
    A
    .
    Prepare the patient to safely let go of therapy.
    B
    .
    Maintain calmness without over-reacting to the patient’s
    behavior.
    C
    .
    Reassure the patient that extinction bursts are reasonable
    and normal.
    D
    .
    ONLY A and B
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  5. In working with an older female patient, the advanced practice psychiatric nurse notices the
    patient seems to respond superficially reminding the advanced practice psychiatric nurse of
    her own mother and finds herself looking forward to their sessions, which recently have been
    going longer than scheduled. The advanced practice psychiatric nurse recognizes this as
    A
    .
    Gerotransference
    B
    .
    Transcendence
    C
    .
    Countertransference
    D
    .
    A sign of a close therapeutic
    relationship
    The Gestalt therapist notices the patient is fidgeting with fingers, legs are shaking and asks
    the patient “What are you experiencing right now in your body?” This is a type of creative
    experimentation known as which of the following?
    A
    .
    Focusing
    B
    .
    Body awareness
    C
    .
    Language of
    responsibility
    D
    .
    Empty-chair dialogue
    Which of the following is a biologically based psychotherapy methodology used to treat
    patients who have experienced trauma?
    A
    .
    Trauma Resiliency Model
    B
    .
    Cognitive Behavioral
    Therapy
    C
    .
    Psychodynamic
    Psychotherapy
    D
    .
    Existential Psychotherapy
    Functional status refers to
    A
    .
    A person’s capacity to manage activities of daily living
    independently
    B
    .
    A person’s positive perspective on their own capabilities
    C
    .
    A person’s expected increase in dependency as one ages
    D
    .
    A person’s expected decrease in independence as one
    ages
    Which of the following is not consistent with the Principles of Effective Treatment for
    Addiction according to the NIH?
    A
    .
    Treatment needs to be readily accessible.
    B
    .
    Psychotropic medication should be stopped prior to treatment.
    C
    .
    Treatment does not need to be voluntary to be effective.
    D
    .
    Drug use during treatment must be monitored continuously as lapses may occur
    during treatment.
    The purpose of Mindfulness-Based Stress Reduction in the older adult is
    A
    .
    To avoid using psychotropic medications
    B
    .
    To escape from stressful situations and
    relationships
    C
    .
    To learn to be present in the moment nonjudgmentally.
    D
    .
    To avoid stigma of traditional psychotherapy
    Critical goals in addiction treatment include improving impulse control, reducing craving,
    and promoting and adaptive social environment. Evidenced based skills that can best impact
    these goals include:
    A
    .
    Life Review Therapy
    B
    .
    Contingency
    Management
    C
    .
    Motivational
    Interviewing
    D
    .
    Interpersonal
    Psychotherapy
    E
    .
    B and C
    In working with a patient with borderline personality disorder, the Dialectical Behavior
    Therapy (DBT) therapist emphasizes suicidal and self-harming behaviors are problems to be
    solved and are the highest priority for treatment. Which of the following would be
    inconsistent with DBT therapy?
    A
    .
    The patient must agree to reduce self-harming behaviors as a goal for therapy.
    B
    .
    The patient must agree to work with the therapist before acting on self-harming
    urges.
    C
    .
    If the patient engages in the self-harming behavior and is admitted to the hospital
    the therapist can continue to support the patient through scheduled telephone or inperson sessions.
    D
    .
    If the patient engages in the self-harming behavior and is admitted to the hospital
    the therapist suspends direct consultation with the patient until 24 hours after the
    patient is discharged from the hospital.
    In following the rules for the Dialectical Behavior Therapy (DBT) therapist, the therapist
    would not do which of the following?
    A
    .
    Recognize the therapist is human and fallible.
    B
    .
    Make every reasonable effort to provide competent treatment for the patient.
    C
    .
    Share the rules for the DBT therapist with the patient during orientation to the
    therapy.
    D
    .
    The therapist agrees to use consultation and allow the patient to view this
    directly if desired.
    Which of the following screening tools is geared toward screening pregnant women for
    alcohol and drug abuse
    A
    .
    CAGEAID
    B
    .
    CRAFFT
    C
    .
    TWEAK
    D
    .
    UNCOPE
    The advanced practice psychiatric nurse proficient in Interpersonal Psychotherapy (IPT) is
    working with an older adult who does not realize she has depression. Which of the following
    is true?
    A
    .
    IPT is not an appropriate model for treating depression in older adults.
    B
    .
    This is a common IPT issue with older adults during the initial sessions.
    C
    .
    The advanced practice psychiatric nurse should consider using a standardized scale
    to quantify the depression and use this to educate the patient and the family.
    D
    .
    B and C
    Which of the following is not consistent with the use of mindfulness in patients requiring
    stabilization following trauma?
    A
    .
    Mindfulness underlies all stabilization.
    B
    .
    Mindfulness is described as having internal and external awareness in abundance.
    C
    .
    Mindfulness allows patient to become fully aware of their experiences and enables
    them to react to their experiences.
    D
    .
    Mindfulness allows patient to become fully aware of their experiences and enables
    them to respond to their experiences.
    Challenges assessing psychiatric symptoms in the elderly include which of the follow
    A
    .
    Denial of symptoms.
    B
    .
    Age-related variations in symptom presentation.
    C
    .
    Making of symptoms by comorbid disorder and
    medications.
    D
    .
    Difficulty in obtaining an accurate mental health
    history.
    In using trauma-focused cognitive behavioral therapy with a child exposed to domestic
    violence the advanced practice psychiatric nurse realizes the first component of this
    structured approach includes which of the following?
    A
    .
    Relaxation skills
    B
    .
    Problem solving skills
    C
    .
    Constructing the trauma narrative
    D
    .
    Psychoeducation with child and parent about trauma response and
    what causes it
    According to a Gestalt framework, to uncritically accept others’ beliefs and standards
    without discriminating and assimilating what belongs to self or not, is a dysfunctional
    process known as which of the following:
    A
    .
    Confluenc
    e
    B
    .
    Projection
    C
    .
    Introjectio
    n
    D
    .
    Retroflecti
    on
    Which of the following is not consistent with what is known about relapse?
    A
    .
    Relapse indicates treatment failure.
    B
    .
    Relapse is a persistent risk in addiction.
    C
    .
    Relapse is a characteristic of all chronic medical diseases.
    D
    .
    Relapse is the return to substance use or addictive behaviors after periods
    of abstinence.
    An advanced practice psychiatric nurse who has been leading groups for patients with
    comorbid PTSD and Substance abuse starts experiencing disturbing dreams, anxiety,
    irritability , withdrawal and problems in interpersonal relationships. These symptoms are
    consistent with the phenomenon of:
    A
    .
    Transference
    B
    .
    Countertransference
    C
    .
    Secondary
    traumatization
    D
    .
    Burnout
    Which of the following statements is consistent with a humanistic-existential approach when
    the patient starts talking about past event?
    A
    .
    Tell me about your childhood.
    B
    .
    Tell me what happened last week.
    C
    .
    Let’s just focus on the here and now.
    D
    .
    Tell me the story as if it were
    happening now.
    Memories of the drug related event may be modified through various therapies including
    which of the following
    A
    .
    CBT
    B
    .
    EMDR
    C
    .
    Pharmacological
    interventions
    D
    .
    All of the above
    Which of the following is not consistent with humanistic-experiential techniques?
    A
    .
    May include working with dreams or the empty chair.
    B
    .
    Use of creative arts such as drawing, music and movement.
    C
    .
    Humanistic-existential therapists interpret for the patient and provide guiding
    advice.
    D
    .
    Humanistic-existential therapists use techniques that are reflective and
    experimental in style.
    In working with an older adult female patient, the advanced practice psychiatric nurse
    notices that the patient starts bringing her baked goods, and says “You remind me so much
    of my daughter, you are so easy to talk to.” The advanced practice psychiatric nurse
    recognizes this as
    A
    .
    Gerotranscenden
    ce
    B
    .
    Transference
    C
    .
    Countertransfere
    nce
    D
    .
    Time for
    termination
    Which of the following trends life trends suggests advanced practice psychiatric nurse be
    prepared to provide mental health and illness treatment in a variety of community and nontraditional settings.
    A
    .
    More older men than women living alone.
    B
    .
    Greatest percentage of older adults living in nursing homes.
    C
    .
    Projected doubling of number of homeless adults between 2010 and
    2050.
    D
    .
    More older adults preferring to leave their homes to seek other living
    arrangements.
    The advanced practice psychiatric nurse using Dialectical Behavior Therapy with a patient
    with borderline personality disorder uses persuasive dialogue to do which of the following?
    A
    .
    Invite the patient to new ways of viewing a situation
    B
    .
    Guiding patient to develop more skills to achieve a greater
    quality of life.
    C
    .
    Engage the patient in change talk
    D
    .
    A and B
    Evidence supports which of the following statements about women and addictions
    treatment?
    A
    .
    Women seeking treatment for substance use disorder are more likely than men to
    have experienced traumatic events.
    B
    .
    Women are more apt to drop out of treatment than men.
    C
    .
    Women are less likely than men to seek mental health services.
    D
    .
    Women are less likely than men to participate in group therapy.
    Which of the following is not consistent with Eye Movement Desensitization and
    Reprocessing (EMDR) literature in treating PTSD?
    A
    .
    Treatment effects are long lasting.
    B
    .
    EMDR involves extended exposure
    C
    .
    EMDR treatment for trauma is less time intensive.
    D
    .
    The aim is to reduce the subject distress and strengthen adaptive beliefs related to
    the traumatic event.
    The advanced practice psychiatric nurse encourages the older adult to recall long forgotten
    experiences, events which are memorable to the person. This is known as
    A
    .
    Life Review Therapy (LRT)
    B
    .
    Reminiscence Therapy (RT)
    C
    .
    A Mindfulness Strategy
    D
    .
    Interpersonal Psychotherapy
    (IPT)
    Dysfunctional processes, developed early in life that people employ in an attempt to meet
    their Needs, are referred to by the Gestalt therapist as which of the following?
    A
    .
    Interruptions
    B
    .
    Figure and ground
    C
    .
    Layers of personality
    D
    .
    Organismic selfregulation
    The therapeutic frame supports the clinician in which of the following ways? Select all that
    apply.
    A
    .
    Maintaining a therapeutic stance of neutrality.
    B
    .
    Maintaining a therapeutic stance of
    anonymity.
    C
    .
    Maintaining a therapeutic stance of nonintrusiveness.
    D
    .
    A and C
    The advanced practice psychiatric nurse is working with a patient with who is chronically
    suicidal. The advanced practice psychiatric nurse using a Dialectical Behavior Therapy (DBT)
    approach realizes which of the following?
    A
    .
    Every time the patient has suicidal ideations hospitalization is recommended.
    B
    .
    To the chronically suicidal patient, hospitalization reinforces the status quo and
    abdicating the hard work of change.
    C
    .
    To the chronically suicidal patient hospitalization frequent hospitalizations allow a
    safe place to learn new coping behaviors and promote change.
    D
    .
    The Advanced practice psychiatric nurse should not be using DBT with a chronically
    suicidal patient.
    The concept of resiliency in child therapies is in direct contrast to which traditional approach
    for treating children?
    A
    .
    Family inclusion
    B
    .
    The concept of recovery
    C
    .
    Problem-based therapy
    D
    .
    Interacting systems
    consideration
    Stigma of mental illness in the elderly:
    A
    .
    Has contributed to psychiatric symptoms being expressed with
    physical symptoms.
    B
    .
    Is much more severe in baby boomers than in other elderly cohorts.
    C
    .
    Is much less an issue in baby boomers than in other elderly cohorts
    D
    .
    Leads to more discussion of emotions in primary care settings.
    Which of the following is not consistent with the Psychoanalyst’s perspective when treating
    and individual with a personality disorder?
    A
    .
    It is important to identify and then modify “core” problems when treating individuals
    with personality disorders.
    B
    .
    Personality structures are unconscious and thus mostly unavailable to the individual.
    C
    .
    Personality products and processes are within the realm of awareness, accessible to
    the individual.
    D
    .
    Psychoanalytic therapy is an effective treatment for Borderline personality disorder
    Which of the following statements would not be consistent with the humanistic-existential
    concept of “holism” ?
    A People are unique.
    .
    B
    .
    The whole is greater than the sum of its parts.
    C
    .
    Mind, body, spirit work in a unified synergistic
    fashion.
    D
    .
    Dysfunctions such as a chemical imbalance must be
    identified.
    Which of the following is true about dreamwork from a Gestalt perspective?
    A
    .
    The individual tells the dream in past tense
    B
    .
    Elements of the dream are viewed using standardized dream symbol
    meaning.
    C
    .
    A dream diary is required to capture all elements of the team.
    D
    .
    The characters and objects in the dream are projections of the individual
    whose dream it is.
    When the advanced practice psychiatric nurse builds a formulation when working with a
    child in therapy the advanced practice psychiatric nurse is doing which of the following?
    A
    .
    Formulation is a type of play therapy.
    B
    .
    Formulation is the child’s diagnosis.
    C
    .
    The formulation explains the contexts of the child and family situation, the child’s
    unique presentation, responses and narratives of the events that shaped the
    interpretation.
    D
    .
    The formulation is the treatment plan.
    In providing psychoeducation to patient’s in recovery, the advanced practice psychiatric
    nurse would not include which of the following?
    A
    .
    Recovery is a lifelong process of change
    B
    .
    A patient is considered recovered after 5 years free of substance use.
    C
    .
    Recovery encompasses dimensions of health, home, purpose and community.
    D
    .
    Recovery applies to recovery from mental disorder, substance use disorders and
    behavioral addictions.
    Which best describes gerotranscendence?
    A Erik Erikson’s ninth stage of development
    .
    B
    .
    Emphasizes ongoing growth over decrements
    C
    .
    Focuses on the transition to old-old (80 years and
    older).
    D
    .
    Focuses on letting go and coming to terms with end
    of one’s life
    The advanced practice psychiatric nurse is working with a group of patients in an outpatient
    substance abuse treatment program. One patient comes to the advanced practice
    psychiatric nurse after the group session and asks if the advanced practice psychiatric nurse
    would meet at a nearby Starbucks to clarify a couple of questions that came up at the end of
    the session and fears relapse. Which of the following would be consistent with the traditional
    therapeutic frame?
    A
    .
    Given concerns about relapse it would be important to meet with the patient just this
    one time and just for 10 minutes but meet in your office.
    B
    .
    Remind the patient that one of the rules is not having contact outside of therapy
    sessions.
    C
    .
    Agree to meet with patient alone in the group room to resolve any outstanding
    concerns from the group.
    D
    .
    Agree to meet with the patient at Starbucks briefly to discuss the unresolved issues,
    but only this once and only for 10 minutes.
    The situation in which increasing amounts of a substance is needed to achieve the same
    desired effect is known as which of the following?
    A
    .
    Addiction
    B
    .
    Tolerance
    C
    .
    Withdraw
    al
    D
    .
    Dependen
    ce
    Which of the following describes the basic neurobiological pathways of the reward system in
    the brain?
    A
    .
    Projections from the ventral tegmental area, through the median forebrain and
    terminate in the nucleus accumbens where there is a proliferation of dopamine
    neurons.
    B
    .
    Projections through the median forebrain, to the ventral tegmental area where there
    is a proliferation of dopamine neurons, to the nucleus accumbens.
    C
    .
    Projections from the nucleus accumbens to the median forebrains where there is a
    proliferation of dopamine neurons to the ventral tegmental area.
    D
    .
    Projections from the median forebrain through the ventral tegmental area to the
    nucleus accumbens where there is a proliferation of dopamine neurons.
    Evidence supports use of Dialectical Behavior Therapy patients with which of the following
    diagnoses?
    A
    .
    Schizophrenia
    B
    .
    New onset depression
    C
    .
    Bipolar Affective Disorder
    D
    .
    Borderline Personality
    Disorder
    The existential concept of an openness, readiness, and flexibility to grow and change, which
    necessitates a capacity to choose alternatives, and shape one’s own destiny as authors of
    creating their own world is which of the following?
    A
    .
    Freedom
    B
    .
    Responsibili
    ty
    C
    .
    Authenticity
    D
    .
    Meaning
    Using a psychodynamic psychotherapy stage oriented model for the treatment of trauma,
    the advanced practice psychiatric nurse would do which of the following in Stage 1?
    A
    .
    Address safety issues
    B
    .
    Promote symptoms
    stabilization
    C
    .
    Process painful memories
    D
    .
    A and C
    The advanced practice psychiatric nurse is working with a patient who states she believes
    her boss hates her. After some discussion, it is clear the patient has strong negative feelings
    towards her boss. The advanced practice psychiatric nurse working within a Gestalt
    framework, recognizes this as an interruption consistent with which of the following?
    A Projection
    .
    B
    .
    Retroflecti
    on
    C
    .
    Confluenc
    e
    D
    .
    Deflection
    The patient in Dialectical Behavior Therapy (DBT) expresses frustration that the skills taught
    don’t work, the process is taking too long, and is struggling to complete homework. The
    advanced practice psychiatric nurse using a DBT model would do which of the following?
    A
    .
    Validate the patient ‘s frustration while encouraging and reinforcing use
    of skills.
    B
    .
    Analyze the behaviors and consequences of the behaviors with the
    patient.
    C
    .
    Focus on behavioral control and management with emotions as a
    contextual element.
    D
    .
    All of the above
    An organized, consistent set of perceptions about the self, continually influenced by
    experience and its interpretation which includes self-worth, self-image and ideal self, is
    which key concept of person-centered therapy?
    A
    .
    Belief of human
    nature
    B
    .
    Self-concept
    C
    .
    Actualizing
    tendency
    D
    .
    Fully functioning
    person
    The advanced practice psychiatric nurse using a Dialectical Behavior Therapy approach with
    a patient with Borderline Personality Disorder explains the four essential elements which
    includes all but which of the following?
    A
    .
    Bi-weekly individual therapy sessions for the patient of about 1 hour each.
    B
    .
    Weekly group skills training sessions for the patient of 2.5 hours each.
    C
    .
    Skills coaching via telephone or other electronic means as needed by the patient to
    manage I vivo situations
    D
    .
    Team consultation to the therapist to maintain treatment fidelity and adherenc
    The advanced practice psychiatric nurse working with a patient with a borderline character
    structure realizes the psychodynamic treatment of choice for those with borderline character
    structure is which of the following?
    A
    .
    Expressive psychotherapy
    B
    .
    Supportive psychotherapy
    C
    .
    Psychoanalytic
    psychotherapy
    D
    .
    A combination of all of the
    above.
    The advanced practice psychiatric nurse working with a patient with borderline personality
    disorder is aware that which of the following attachment styles has been highly correlated
    with Borderline personality disorder?
    A
    .
    Secure attachment style
    B
    .
    Unresolved attachment
    style
    C
    .
    Preoccupied attachment
    style
    D
    .
    Disorganized attachment
    style
    The advanced practice psychiatric nurse using supportive psychotherapy with a patient with
    a preoccupied attachment style would use which of the following interventions?
    A
    .
    Active interventions to facilitate emotional expression and
    connection.
    B
    .
    Supportive interventions to help the patient contain overwhelming
    emotions.
    C
    .
    Any interventions on the psychodynamic continuum with not
    customizations.
    D
    .
    None of the above. Attachment style has no bearing on
    psychodynamic therapy.
    The patient in Dialectical Behavior Therapy (DBT) is focusing of self-efficacy,
    interdependence and self-dependence. At times, the patient seems bored with therapy, and
    reports dealing quickly and effectively with self-harming urges that have resurfaced. The
    advanced practice psychiatric nurse using the DBT model would do which of the following?
    A
    .
    Do nothing different.
    B
    .
    Increase the frequency and intensity of contact.
    C
    .
    Decrease the frequency and intensity of contact.
    D
    .
    Express concern to the patient about premature distancing
    and regression
    Which of the following is not consistent with the Cognitive Behavioral therapist perspective
    when treating and individual with a personality disorder?
    A
    .
    It is important to identify and then modify “core “problems when treating individuals
    with personality disorders.
    B
    .
    Personality structures are unconscious and mostly unavailable to the individual.
    C
    .
    Personality products and processes are within the realm of awareness, mostly
    accessible to the individual.
    D
    .
    Dysfunctional behaviors, thoughts and feelings are largely due to the function of
    schemas.
    Strategies for terminating a therapy relationship with an older adult includes:
    A
    .
    The advanced practice psychiatric nurse needs to develop a checklist to determine
    goals have been made and it is time to terminate.
    B
    .
    The advanced practice psychiatric nurse determines therapy goals attained,
    terminate the therapeutic relationship, and schedule to meet the patient for coffee to
    ease the transition out of therapy.
    C
    .
    The advanced practice psychiatric nurse should set clear therapy goals, commend
    patient on goal attainment and terminate the therapy.
    D
    .
    Termination should occur by mutual decision between advanced practice psychiatric
    nurse and patient based on the therapy goals attained.
    The most effective treatment for SUD with or without co-morbid psychiatric disorders is:
    A
    .
    Multidimensional addressing medical, psychosocial and mental
    health issues
    B
    .
    Trauma-informed care.
    C
    .
    12-Step Peer Support Groups
    D
    .
    Cognitive Behavioral Therapy
    The stabilization skills and concepts that form the foundation of Trauma Resiliency Model
    stand alone as a model in and of itself called CRM. CRM stands for which of the following?
    A
    .
    Cognitive Restructuring
    Model
    B
    .
    Cognitive Resiliency
    Model
    C
    .
    Community Resiliency
    Model
    D
    .
    Cognitive Regeneration
    Model
    The advanced practice psychiatric nurse working with a patient with SUD provides a $25
    voucher for a retail purchase in recognition of one month’s sobriety and clean drug screens.
    This intervention is most consistent with which therapeutic approach?
    A
    .
    Motivational Interviewing
    B
    .
    Contingency Management
    C
    .
    Dialectical Behavioral
    Therapy
    D
    .
    Cognitive Behavioral Coping
    Skills
    A patient whose husband had recently died suddenly expresses remorse regarding an
    argument they had shortly before his death. The Gestalt Therapist would likely use which of
    the following techniques to complete unfinished business?
    A
    .
    Focusing
    B
    .
    Dreamwork
    C
    .
    Empty-chair dialogue
    D
    .
    Language of
    responsibility
    According to Dearing, Stuewig, and Tangney (2005), understanding the difference between
    guilt and shame and its impact on an individual’s motivation is critical to hope and the
    recovery process. Which of the following is true regarding guilt and shame?
    A
    .
    Shame drives a person to engage in treatment while guilt drives a person to avoid
    treatment.
    B
    .
    Shame causes a person to perceive self as a failure and guilt causes avoidance of
    treatment.
    C
    .
    Guilt causes a person to perceive himself as a loser and shame drives a person to
    avoid treatment.
    D
    .
    Shame drives avoidance from treatment, Guilt often motivates a person to seek
    treatment
    A natural process whereby the individual is continually disturbed by the emergence of a
    need, strives to restore equilibrium by constantly reorganizing and adapting to changing
    circumstances in recognized by the Gestalt therapist as which of the following?
    A
    .
    Figure and ground
    B
    .
    Organismic selfregulation
    C
    .
    Layers of the
    personality
    D
    .
    None of the above
    ORDER THIS EXAM HERE
  6. Which of the following would not be a first-line intervention for an individual with PTSD?
    A
    .
    CPT
    B
    .
    CPT-PE
    C
    .
    EMDR therapy
    D
    .
    Pharmacological
    interventions.
    The mother of a 6-year-old is concerned that the child seems to always want to pretend
    when playing. Which would be an appropriate response to the mother?
    A
    .
    This shows some regression as most children of this age are in the concrete
    operational stage and play should be more realistic.
    B
    .
    This is an appropriate activity for a child of this age consistent with Piaget’s
    sensorimotor stage.
    C
    .
    Pretend play is an appropriate activity for a child in the Preoperational stage of
    cognitive development.
    D
    .
    Pretend play shows the ability to think abstractly which indicates cognitive ability
    consistent with the formal operational stage of cognitive development.
    Techniques used by the Gestalt therapist include which of the following?
    A
    .
    The ability to provide homework
    B
    .
    The ability to craft creative experiments
    C
    .
    The ability to establish an authentic I-Thou relationship with
    the patient.
    D
    .
    B and C
    When doing psychotherapy with older adult’s accommodations which target cognitive
    symptoms and functional deficits include:
    A
    .
    Shorter, more frequent sessions
    B
    .
    Summarizing previous sessions
    C
    .
    Quizzing patient on previous sessions
    D
    .
    Insist the patient bring a notebook and
    take note
    The advanced practice psychiatric nurse encourages a patient with gambling addiction to
    develop a relapse prevention plan. Which of the following is true about a relapse prevention
    plan?
    A
    .
    A relapse prevention plan includes identifying triggers to the patient’s gambling and
    a variety of coping strategies to avoid or successfully manage triggers without
    reverting to gambling.
    B
    .
    A relapse prevention plan should be completed during the initial stage of treatment.
    C
    .
    The main focus of a relapse prevention plan is on changing behaviors.
    D
    .
    The main focus of a relapse prevention plan is on cognitive or thought processes to
    decrease the desire to gamble
    Which of the following is not true about self-regulation as it applies to therapy with children?
    A
    .
    Self-regulation is a developmental milestone of childhood in which the child controls
    behavior in the service of socially desirable conduct.
    B
    .
    Self-regulation is a pivotal developmental process of integrating emotion, memory
    and behavior.
    C
    .
    Self-regulation mechanisms from a neuroscience perspective are basic mechanisms
    predominantly located in the globus pallidus.
    D
    .
    Self-regulation issues are often seen in various child psychopathology.
    Which of the following is not consistent with a “traditional” treatment frame?
    A
    .
    Enforcing established starting and ending times for each session.
    B
    .
    Establishing and enforcing a clear policy in regard to payment.
    C
    .
    Canceling sessions if the patient arrives under the influence of alcohol or
    psychoactive drugs.
    D
    .
    Disclosing home or cellular phone number of therapist for emergency use
    only.
    Which of the following is consistent with Life Review Therapy?
    A
    .
    Appropriate for cognitively intact to moderately impaired older
    adults.
    B
    .
    Focuses on past event or experiences, not current events.
    C
    .
    The patient is typically self-focused, usually experiencing a life
    event trigger.
    D
    .
    Results in decreased isolation.
    The advanced practice psychiatric nurse working with a child exposed to a traumatic event
    using trauma-focused cognitive behavioral therapy recognizes E in the acronym PRACTICE
    represents which therapeutic component of this therapeutic approach?
    A
    .
    Exposure
    B
    .
    Education
    C
    .
    Energizing
    D
    .
    Enhancing
    safety